The objectives of the Mississippi Experimental Medical Care Review Organization are (1) to continue the development of a hospital inpatient care review system designed to evaluate the appropriateness of hospital admission, appropriateness of services received while in the hospital, and appropriateness of the length of hospital stay; (2) to continue the development of a hospital emergency room care review system designed to evaluate emergency medical treatment and to review the structural and functional aspects of emergency departments. This objective will be closely aligned to the inpatient care review system; (3) to study the use of measurements of patient outcome to judge care quality in conjunction with the forementioned systems. This will include studying methods of using process data to identify differences in outcome groups of patients who did or did not receive all elements of expected care; and (4) to extend the EMCRO's hospital-based concurrent care review and length of stay monitoring program into skilled nursing facilities. The development of this program is proposed, although the intent is to establish the same type of review and monitoring as the EMCRO has developed for the acute care hospital.